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Maxillary sinus septum;panoramic radiographic and dental computed tomographic analyses in the planning of implant surgery (상악동 중격;임플란트 수술 계획시 파노라마와 치과용 전산화 단충촬영 분석)

  • So, Hyun-Ja;Jeong, Dong-Keun;Kwon, Jin-Hee;Ryu, So-Hyun;Kim, Hyung-Seop
    • Journal of Periodontal and Implant Science
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    • v.36 no.1
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    • pp.147-154
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    • 2006
  • Surgical intervention in the posterior maxillary region requires detailed knowledge of maxillary sinus anatomy and the possible anatomical variations. This study evaluated the incidence, location of maxillary sinus septa by using radiographic (panoramic radiography and computed tomography) findings and comparison of panoramic radography with CT in antral anatomical variation. This study was based on data from 70 sinuses in partial dentate maxilla. The sample consisted of 61 patients(25 women and 36 men, with ages ranging between 19 and 77 years and a mean age of $49.4{\pm}11.3$ years) who were being treatment-planned to receive implant-supported restorations. First, the panoramic images were examined for the presence of antral septa by radiologist and examiner who don't know about CT findings. And incidence of antral septa was evaluated using an axial plane of CT image. The incidence of septa was compared between panoramic radiography and CT. The accuracy of the incidence was compared between radiologists and dentists. A total of 20 septa were found in 70 sinuses on CT image and the prevalence of one or more septa per sinus was found to be 28.6%. The assumed incidence of septa on panoramic radiography was $27.6%{\pm}2.2%$ in radiologist and $31.9%{\pm}5.8%$ in dentists. Erroneous diagnosis rate was 11.42% in radiologist and 15.96% in dentists. 40% of antral septa were located in the anterior(premolar) region, 30% of septa were located in the middle(first molar) and posterior(second molar) region separately. Prior to implant placement, it seems appropriate to consider panoramic radiography as a standard radiographic examination and periapical radiographs may be used to complete the findings in regions not sharply depicted in the panoramic radiograph. And cross-sectional imaging should be used in sites with severe bone loss and close proximity of the maxillary sinus.

Influence of crown-to-implant ratio on periimplant marginal bone loss in the posterior region: a five-year retrospective study

  • Lee, Kyung-Jin;Kim, Yong-Gun;Park, Jin-Woo;Lee, Jae-Mok;Suh, Jo-Young
    • Journal of Periodontal and Implant Science
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    • v.42 no.6
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    • pp.231-236
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    • 2012
  • Purpose: The aim of this study was to evaluate the influence of the crown-to-implant (C/I) ratio on the change in marginal bone level around the implant and to determine the site-related factors influencing the relationship between the C/I ratio and periimplant marginal bone loss. Methods: A total of 259 implants from 175 patients were evaluated at a mean follow-up of five years. Implants were divided into two groups according to their C/I ratios: ${\leq}$ 1, and >1. Site-related factors having an influence on the relationship between C/I ratio and periimplant marginal bone loss were analyzed according to the implant location, implant diameter, implant manufacturer, prosthesis type, and guided bone regeneration (GBR) procedure. Results: It was found that 1) implants with a C/I ratio below 1 exhibited greater periimplant marginal bone loss than implants with a C/I ratio more than 1, 2) site-related factors had an effect on periimplant marginal bone loss, except for the implant system used, 3) the C/I ratio was the factor having more dominant influence on periimplant marginal bone loss, compared with implant diameter, prosthesis type, implant location, and GBR procedure, 4) implants with a C/I ratio below 1 showed greater periimplant marginal bone loss than implants with a C/I ratio greater than 1 in the maxilla, but not in the mandible, 5) and periimplant marginal bone loss was more affected by the implant system than the C/I ratio. Conclusions: Within the limitations of this study, implants with a higher C/I ratio exhibited less marginal bone loss than implants with a lower C/I ratio in the posterior regions. The C/I ratio was a more dominant factor affecting periimplant marginal bone loss in the maxilla than the mandible. Meanwhile, the implant system was a more dominant factor influencing periimplant marginal bone loss than the C/I ratio.

Influence of platform switching on crestal bone resorption (치조정 골흡수에 대한 platform switching이 미치는 영향)

  • Kim, Do-Young;Kim, Tae-Il;Seol, Yang-Jo;Lee, Yong-Moo;Ku, Young;Rhyu, In-Chul;Chung, Chong-Pyoung;Han, Soo-Boo
    • Journal of Periodontal and Implant Science
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    • v.38 no.2
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    • pp.135-142
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    • 2008
  • Purpose: Numerous studies have shown that crestal bone resorption around the implant was related to the location of the implant abutment junction(IAJ). Recently it was hypothesized that platform switching termed the inward horizontal repositioning of the IAJ might limit bone resorption around the implants. The purpose of this clinical study was to evaluate the effect of platform switching on crestal bone resorption. Materials and Methods: The crestal bone loss of 65 external hex implants in 26 patients were radiographically measured at crown placement and follow-up examinations. 23 standard implants(non-platform switching group, NP) were connected with the matching abutments and 42 wide implants(platform switching group, PS) were connected with the 1 mm smaller diameter abutments. Results: There was significant difference of crestal bone loss between NP group and PS group. For implants in the NP group, mean crestal bone loss was $1.18{\pm}0.68\;mm$ at crown placement and $1.42{\pm}0.41\;mm$ at follow-up. The meal bone loss in PS group was $0.47{\pm}0.52\;mm$ at crown placement and $0.60{\pm}0.65\;mm$ at follow-up. When the crestal bone changes according to placement depths of implants were compared, subcrestal position of IAJ had a significantly less bone loss in PS group, but it was not in NP group. Conclusion: Within the limits of the present study, it was concluded that platform switching technique might decrease crestal bone loss around the implants. Additionally, when the IAJ of implant was placed 1 mm deeper in the alveolar bone, the effect of platform switching on bone loss was enhanced.

Retrospective Study of the Characteristics and Treatment of Odontomas (치아종의 임상적 특징과 치료에 대한 후향적 연구)

  • Moon, Yujin;Lee, Daewoo;Kim, Jaegon;Baik, Byeongju;Yang, Yeonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.2
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    • pp.164-171
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    • 2015
  • This study was aimed to retrospectively evaluate the clinical findings and treatments of odontomas in the Korean demographic group. The subject of the present study included 75 odontomas in 74 patients who received treatment from Chonbuk National University Dental Hospital between April 2005 and March 2014. The average age of the subjects were 10.3 years old (range 3 - 23 years old). 42 (56.8%) males and 32 (43.2%) females were in the present study. It was found that compound odontomas were about 4 times more common than complex odontomas. Odontomas equally occurred in both maxillary and mandible. The impaction of permanent teeth (73.3%) was the most common complication of odontomas on adjacent teeth. Most odontomas (96.0%) were surgically removed either to induce spontaneous eruption or to guide orthodontically to occlusion. When the impacted tooth could not be naturally or forcefully erupted to occlusion, it was extracted. Early detection and treatment of odontomas would increase the possible preservation of the impacted tooth by eliminating the source of disturbance. Therefore, this study recommends that periodic radiographic examination from birth until the eruption of the permanent third molar to prevent possible hindrance to the teeth eruption.

Early Marginal Bone Loss around Submerged Implants According to the Patterns of Cover Screw Exposures (Submerged 임플란트에서 덮개나사 노출 양상에 따른 조기 변연골 상실)

  • Choi, Mee-Ra;Park, Chan-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.2
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    • pp.175-182
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    • 2013
  • The purpose of this study was to observe and analyze the initial marginal bone resorption changes according to the patterns of cover screw exposures during healing period followed by implants installation. Total 64 fixtures(TiUniteTM, NobelBiocare, Sweden) were installed in partially edentulous jaws of 28 patients, who were selected retrospectively and were shown at least one cover screw exposure. Cover screw exposures were defined at 1 month recall. According to the patterns of exposures, groups were categorized into group 1 (No exposure), group 2 (pin-point exposure), group 3 (less than 1/2 of cover screw), group 4 (more than 1/2 of cover screw), group 5 (total exposure). Periapical radiographs were taken in purpose of changes of marginal bone level between installation and 2 month recall. Healing abutments were secured on the exposure groups at 2 month recall. Results were as follows: 1. Marginal bone resorptions were identified whenever cover screws were exposed. 2. Group 2 and 3 were shown significantly increased bone loss more than other group (P <.05). 3. Group 4 and 5 were shown significantly increased bone loss more than group 1, however, less than other groups ( P <.05). Conclusionally, cover screw exposure may cause marginal bone resorptions, therefore, early connection of healing abutment is clinically helpful.

DIFFERENTIAL DIAGNOSIS BY JOINT CAVITY PUMPING WITH LOCAL ANESTHETIC FOR PAIN OF TEMPOROMANDIBULAR JOINT ARTHROSIS (악관절증의 동통에 대한 국소마취제의 관절강내 Pumping에 의한 감별법)

  • Chung, Hoon;Jung, Hak;Kino, Koji
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.14 no.1_2
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    • pp.146-153
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    • 1992
  • In the outpatient clinic, we have many patients who suffer from temporomandibular joint disorders. These vary from MPD syndrome to osteoarthrosis, and many cases have tender spots or areas on the temporomandibular joint region and/or masticatory muscles. Further, they frequently have masticatory muscle pain when opening the jaw. This paper presents the results of our research on the differential diagnosis for tendernesses and pain on opening the jaw in the temporomandibular joint region and the masticatory muscles by joint cavity pumping with local anesthestic. The areas of tenderness and jae-opening paw in 65 patient suffering from temporomandibular joint disorder were examined and recorded before and after anesthetizing the upper joint cavity with 2% lidocaine. Maximum interincisal distance was similarly recorded. The results were as follows : In the area surrounding the upper joint cavity including the lateral pterygoid muscle, the tenderness and jaw-opening pain vanished almost entirely after anesthesia. This was considered a direct infiltrative effect of the local anesthesia. After the anesthesia, 86% of the tendernesses on the sternocleidomastoid muscles, and 66% of those on the posterior belly of the diagstric muscles vanished, while the disappearance rates on the masseter, temporal, and medial pterygoid muscles were 50~60%. Apart from the temporomandibular region, pain on opening the jaw was found on the masseter, temporal, posterior belly of the digastric muscles, and medial pterygoid muscles before anesthesia. The disappearance rates after anesthesia were 90~100% except for the pain of the posterior belly of the digastric muscles, for which the rate was 66%. These results suggest that more than 88% of the tendernesses on the sternocleidomastoid muscle, more than 60% of the tendernesses and jaw-opening pains on the digastric muscle, and more than half of the tendernesses and almost all of the jaw-opening pains in the jaw-closing muscles are referred pains from the temporomandibular joint. The tendernesses that had no change after anesthesia were considered to be derived from spasms of the muscles proper. Generally, maximum interincisal distance increased after anesthesia. The average distance was 34mm before anesthesia, but increased to 41mm after anesthesia. In a few cases, however little or no change was found in those distances. In these cases, pathological changes were found in the joint cavities arthrographically or arthroscopically.

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THE TOPICAL ANESTHESIA WITH EMLA CREAM IN CHILDREN : A CASE REPORT (소아에서 EMLA cream을 이용한 도포마취 : 증례보고)

  • Kim, He-Jin;Ko, Sung-Back;Hong, Seong-Soo;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.1
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    • pp.69-75
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    • 2002
  • A number of techniques may be employed to reduce the discomfort of syringe or needle for dental care. The use of topical anesthesia is one such method. Topical anesthetics are applied to alleviate pain during many clinical procedures, such as injection of local infiltration anesthetics, primary tooth extraction, X-ray taking of sensitive patients, reducing gag reflex prior to impression taking. In children, placement of a rubber dam clamp, however, may cause significant discomfort for purpose of pit and fissure sealant and preventive resin restoration(PRR). A topical anesthetic would be beneficial to aid in rubber dam placement for this purpose. It has been suggested that all intra-oral topical anesthetics are equally effective on reflected mucosa, however EMLA(an acronym for eutectic mixture of local anesthetics), which was developed in the 1980s and produces surface anesthesia of skin, has been shown to be more effective than conventional topical anesthetics when used on attached gingivae. This report is topical anesthesized 4 case by EMLA cream, who showed better effect in reducing the pain of infiltration anesthesia, extraction of deciduous teeth, rubber dam clamp placement and reducing the pain of preformed crown adaptation.

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Development of A Fractionated Stereotactic Radiotherapy System (분할 정위방사선 치료 시스템 개발 연구)

  • 이동한;지영훈;이동훈;조철구;김미숙;유형준;류성렬
    • Progress in Medical Physics
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    • v.13 no.1
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    • pp.9-14
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    • 2002
  • We invented the newly developed Fractionated Stereotactic Radiotherapy(F.S.R.T) system using combined techniques of couch mounting and pedestal mounting system. Head fixation frame consists of a milled alluminium alloy(duralumin) and is placed to the couch. This frame immobilized patient head using the dental bite, 3.2 mm frontal and occipital thermoplastic mask. To evaluate the coordinate of target isocenter, Brown-Revert-Walls C.T localizer can be attached to this frame. And also, we developed the frame mounting system by developing the modification of pedestal mounting system. This system is fixed to couch floor and can be used to evaluate the isocenteric accuracy of gantry, couch and collimator in Q.A procedure. In order to measure the relocation accuracy, the acrylic phantom and the accurate pointers have been made. The repositioning of the targets in the phantom were estimated by comparing C.T coordinates and E.C.L portal films taken with anterior-posterior and right-left direction. From the results of experiments, the average distance errors between the target isocenter and its mean position were 0.71$\pm$0.19 for lateral, 0.45$\pm$0.15 for inferior-superior, 0.63$\pm$0.18 for anterior-posterior. And the maximum distance error was less than 1.3 mm. The new head fixation frame and frame mounting system were non-invasive, accurately relocatable, easy to use, very light and well tolerable by the results of phantom tests. The major advantage of using this frame mounting system is complete access to any point in the Patients cranium especially posterior direction

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A CEPHALOMETRIC STUDY ON CHANGES OF FACIAL MORPHOLOGY IN THE FRONTAL VIEW FOLLOWING MANDIBLE SETBACK SURGERY ( BSSRO ) IN PATIENTS WITH SKELETAL CLASS III DENTOFACIAL DEFORMITIES (골격성 제3급 부정교합환자의 하악지 시상분할 골절단술후 하안면 폭경 및 고경의 변화에 대한 두부계측 방사선학적 연구)

  • Jang, Hyon-Seok;Rim, Jae-Suk;Kwon, Jong-Jin;Lee, Bu-Kyu;Son, Hyoung-Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.3
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    • pp.337-342
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    • 2000
  • Purpose : The purpose of this study was to analyze the lower third facial changes in frontal view after mandibular setback surgery. Materials and Methods : In this study, fifteen subjects(6 males and 9 females) with class III dental and skeletal malocclusions who were treated with BSSRO(Bilateral Sagittal Split Ramus Ostetomy) were used. Frontal cephalometric radiographs were taken preoperatively and more than 6 months postoperatively, and hard tissue(H2-Hl) and soft tissue changes (S2-S1) were measured on vertical and horizontal reference lines. In 15 cases, changes which developed more than 6 months after surgery were studied. Results : The results were as follows. 1. In the facial height, hard tissue $decreased(2.46{\pm}2.76mm)$ with statistical significance(P<0.01), and soft tissue also $decreased(1.64{\pm}3.66mm)$. As a result, the facial height generally becomes shorter after sagittal split ramus osteotomy. 2. In the mandibular width, hard tissue $decreased(2.08{\pm}3.59mm)$ with statistical sgnificance(P<0.05), but soft tissue $increased (2.14{\pm}5.73mm)$ without statistically significant difference(P>0.05) postoperatively. 3. In the facial index, hard tissue $decreased(0.23{\pm}2.21%)$, but soft tissue $increased(2.41{\pm}3.46%)$ with statistical significance. Conclusion : One of the main purpose of orthognathic surgery is to achieve facial esthetics and harmony. In order to fullfill this purpose, it is important to carry out a precise presurgical treatment planning by estimating the changes of frontal profile after surgery.

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A study on the changes of the posterior segments between before, after treatment and postretention period through maxillary expansion therapy (상악궁 확장술을 통한 치료전, 후 및 보정후 상악 구치부 변화에 관한 연구)

  • Park, Tae-Seo;Lee, Jin-Woo;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.27 no.1
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    • pp.55-63
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    • 1997
  • The purpose of thus study was to measure the changes of arch and dentition of maxillary posterior teeth before and after treatment and postretentios in patients treated with Quad-helix. Measurements and analysis were performed on study model with carlipers. Seventeen cases, eight boys and nine girls, were selected with average ages of 12.7 years. Mean retention period was 4 months, and mean wearing time was. 127 days. The result were as follows 1. The interpremolar widths and intermolar width were significantly increased in maxillary first piennolar and molar when compared between before and after treatment and postretention. The maxillary second premolar resulted in significant increase in interpremolar between after tretment and post retention. 2. The long axis of maxillary first premolar and first molar accompaning buccal tipping was significant increased before and after Tx and post retention. Significant increase of the lingual inclination of maxillary second premolar was obsered both in before and after Tx, and before Tx and post retention. 3. The distance between the height of tooth contour was significantly increased in the first and second premolar before and after Tx, and was significant increased in the first molar before and after Tx and post retention. 4. Intermolar width at the palatal groove was increased in before and after Tx. and post retention. The palatal depth was significant increased in before and after Tx. In conclusion expansion of maxillary dental arch showed no relapse and results were stable retention

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